Provider Demographics
NPI:1235919093
Name:CULVER-GONZALEZ, AMI (LPCC)
Entity Type:Individual
Prefix:
First Name:AMI
Middle Name:
Last Name:CULVER-GONZALEZ
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:AMI
Other - Middle Name:
Other - Last Name:CULVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26370 TEAL CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91387-6327
Mailing Address - Country:US
Mailing Address - Phone:805-358-6506
Mailing Address - Fax:
Practice Address - Street 1:21508 CENTRE POINTE PKWY
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-2947
Practice Address - Country:US
Practice Address - Phone:661-253-4400
Practice Address - Fax:661-352-4125
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3129101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health